Understanding your insurance terminology can help you avoid surprises and better manage your financial responsibility for care. At ReachLink, we prioritize transparency so you can focus on your therapy. Here are the most important terms ReachLink clients should know.
Deductible
The amount you must pay out-of-pocket for covered services before your insurance begins to pay. For example, if your deductible is $500, you pay the first $500 of eligible services each year.
Copay / Coinsurance
These are the amounts due for each session and are collected at the time of confirmation.
- Copay: A fixed dollar amount you pay for a covered service (e.g., $30 per therapy session).
- Coinsurance: A percentage of the cost you pay for a covered service after your deductible has been met (e.g., 20% of the session cost).
Out-of-Pocket Maximum (OOP)
The most you will pay in a plan year for covered services. After reaching this limit, your health plan covers 100% of eligible costs.
Applied to Deductible (ATD)
Indicates that a charge is being counted toward your deductible, meaning you still owe that amount until your annual deductible is met.
In-Network (INN) / Out-of-Network (OON)
- In-Network: Providers who have a contract with your insurance plan. You usually pay lower costs for their services.
- Out-of-Network: Providers without a contract. You may pay higher costs or your plan may not cover the service at all.
Billed Amount vs. Patient Responsibility
- Billed Amount: The total charge submitted by your provider to your insurance.
- Patient Responsibility: The actual amount you are responsible for paying, which can include copays, coinsurance, and any amount applied to your deductible. This is often less than the billed amount.
Cost Share
The portion of a medical bill you are responsible for paying. This includes copays, coinsurance, and deductible payments.
Need Assistance?
- In the app: Use Get Help
- Email: support@reachlink.com